A Focus On Behaviors Instead Of Thoughts Works Best To Increase Patient Physical Activity

Most people know that exercise is important to maintain and improve health; however, sedentary lifestyles and obesity rates are at all-time highs and have become major national issues. In a new study, University of Missouri researchers found that healthy adults who received interventions focused on behavior-changing strategies significantly increased their physical activity levels. Conversely, interventions based on cognitive approaches, which try to change knowledge and attitudes, did not improve physical activity.

“The focus needs to shift from increasing knowledge about the benefits of exercise to discussing strategies to change behaviors and increase activity levels,” said Vicki Conn, associate dean for research and Potter-Brinton professor in the MU Sinclair School of Nursing. “The common approach is to try and change people’s attitudes or beliefs about exercise and why it’s important, but that information isn’t motivating. We can’t ‘think’ ourselves into being more active.”

Behavior strategies include feedback, goal setting, self-monitoring, exercise prescription, and stimulus or cues. Self-monitoring, any method where participants record and track their activity over time, appears to significantly increase awareness and provide motivation for improvement, Conn said.

“Health care providers should ask patients about their exercise habits and help them set specific, manageable goals,” Conn said. “Ask them to try different strategies, such as tracking their progress, scheduling exercise on their phones or calendars, or placing their pedometers by their clothes. Discuss rewards for accomplishing goals.”

The study, featured in the American Journal of Public Health, incorporated data from 358 reports and 99,011 participants. The researchers identified behavioral strategies were most effective in increasing physical activity among healthy adults. Successful interventions were delivered face-to-face instead of mediated (i.e., via telephone, mail, etc.) and targeted individuals instead of communities.

“The thought of exercise may be overwhelming, but slowly increasing activity by just 10 minutes a day adds up weekly and is enough to provide health benefits,” Conn said. “Even small increases in physical activity will enhance protection against chronic illnesses, including heart disease and diabetes. Preventing or delaying chronic disease will reduce complications, health care costs, and overall burden.”

Previously, Conn completed a meta-analysis of interventions for chronically ill patients and found similar results. Conn found that interventions were similarly effective regardless of gender, age, ethnicity, and socioeconomic status.

The study, “Interventions to increase physical activity among healthy adults: Meta-analysis of outcomes,” is featured in this month’s issue of the American Journal of Public Health. Conn’s research is funded by a more than $1 million grant from the National Institutes of Health.